TPS881 Background: The NMIBC population is emblematic of older patients with cancer, with a high burden of frailty, sarcopenia, mobility impairment, and multimorbidity. “Exercise as Medicine” has emerged as a critical component of comprehensive cancer care with reported benefits across physical, mental, emotional, and social domains as well as oncologic outcomes. However, most adults with cancer do not meet recommended physical activity guidelines. We are conducting a randomized controlled trial comparing the efficacy of a home-based physical activity program (PAP) delivered via the ExerciseRx digital health tool to guideline-based Health Education (HE) with respect to 1) improvement of physical function and 2) impact on health-related quality of life, frailty, treatment-associated toxicity, and oncologic outcomes. Methods: We will recruit and randomize 100 patients in a 1:1 ratio to PAP or HE arms. The PAP arm will be provided with a 12-week personalized, home-based exercise program (~20-30 minutes, 4x weekly) via the ExerciseRx app as well as a weekly graded progression in personalized step count goals. The HE arm will receive printed education on guideline-based exercise recommendations in line with National Comprehensive Cancer Network (NCCN) Survivorship for Healthy Living Guidelines. The ExerciseRx platform is comprised of 1) a provider dashboard embedded in the electronic health record, for recommending exercises and monitoring progress, and 2) a patient app, that delivers exercise plans and tracks exercise repetitions using native sensors in smart devices. Step count in both study groups will be tracked with Fitbit (Inspire 3). Eligibility criteria: English-speaking adults ( > 18 years) with a history of NMIBC who are willing and able to participate in walking and home exercise safely. The primary outcome of interest is the change in average daily Fitbit-assessed step count between baseline and 12 weeks, and 4-weeks after intervention completion (16 weeks). Secondary outcomes include change in Short Physical Performance Battery performance, patient-reported quality of life (EORTC-QLQ-C30, -NMIBC24), and frailty (Cancer and Aging Resilience Evaluation), Treatment burden and PRO-CTCAE v.6.0 assessed side effects, exercise-related AEs, and Resilience. Feasibility, usability, and app utilization metrics will be assessed. Enrollment will commence 2/2026. NCT pending.
Psutka et al. (Sun,) studied this question.